title: Are antibiotics indicated as an initial treatment for patients with acute upper respiratory tract infections? A review.
abstract: OBJECTIVE
  To determine the effect of antibiotic treatment versus placebo in patients with acute upper respiratory tract infections.
  
  
  METHODS
  A systematic review and meta-analysis examined the effect of antibiotics versus placebo in randomised controlled trials to initially treat acute upper respiratory tract infections.
  
  
  RESULTS
  Eight studies of children from age 6 months and adults up to the age of 49 years were found. The main outcome measures were general improvement and adverse effects. No benefit was demonstrated in terms of overall improvement from the use of antibiotics compared to placebo for patients with acute upper respiratory tract infections RR=0.89 (95%CI 0.77-1.04). There was also a significant increase in adverse effects (mainly gastrointestinal) using a random effects model with a relative risk RR=2.71 (95%CI 1.08-6.83).
  
  
  CONCLUSIONS
  Initial use of antibiotics do not benefit patients with acute upper respiratory tract infections and are associated with an increase in adverse effects.
authors.affiliation: Dept of General Practice and Primary Health Care University of Auckland, Private Bag 92019, Auckland, New Zealand. b.arroll@auckland.ac.nz
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
authors.forename: Tim
authors.initials: T
authors.lastname: Kenealy
authors.forename: Karen
authors.initials: K
authors.lastname: Falloon
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents